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. 2025 Apr;37(2):e70036.
doi: 10.1111/1742-6723.70036.

Impact of an evidence-based sepsis pathway on paediatric hospital clinical practice: A quality improvement study

Bernard McCarthy  1   2 , Natalie Middleton  2 , Fenella J Gill  2   3 , Zoy Goff  2   4 , Zoe Paterson  2 , Christopher C Blyth  2   4   5   6   7 ; CAHS Sepsis Working Group  2
Collaborators, Affiliations

Impact of an evidence-based sepsis pathway on paediatric hospital clinical practice: A quality improvement study

Bernard McCarthy et al. Emerg Med Australas. 2025 Apr.

Abstract

Objectives: To assess the impact of implementing a sepsis pathway and education program on key sepsis outcomes and performance targets in a tertiary paediatric hospital.

Methods: A quality improvement study using a multi-modal screening process and pragmatic clinical definitions. Treatment of all children with septic shock and sepsis without shock 4 months prior to pathway/education package launch was compared with those meeting definitions 8 months post-launch.

Results: Over the study period, 1483 episodes were screened; 517 episodes met study definitions (171 pre-launch; 346 post-launch). Eighty-two episodes met septic shock definitions (15.9%) and 435 met sepsis without shock definitions (84.1%). A total of 143 episodes pre-launch and 271 episodes post-launch were managed exclusively at Perth Children's Hospital (PCH). Post intervention, the pathway form was utilised in 146 of 271 episodes (53.9%). Pathway/education package introduction was associated with a reduction in the median time from recognition to antibiotic administration (60 [IQR: 26; 115] to 45 min [IQR: 16; 75] for those with septic shock and/or sepsis without shock treated exclusively at PCH; P < 0.001). The proportion receiving antibiotic therapy within recommended timeframes significantly increased (septic shock within 60 min: 70.0% to 92.5%, P < 0.03; sepsis without shock within 180 min; 86.2% to 94.8%, P = 0.005). No statistically significant change in length of stay, intensive care admission, mortality or antibiotic consumption was observed following pathway launch.

Conclusions: Paediatric sepsis pathway and education package implementation can reduce time to antibiotics in sepsis and aid local data collection and surveillance of patients treated for sepsis.

Keywords: audit; paediatric; quality improvement study; sepsis clinical care standard; sepsis pathway.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Flow diagram of patient inclusion.
Figure 2
Figure 2
Box and whisker plot demonstrating a significant reduction in time (minutes) to appropriate antibiotic therapy following launch.
See this image and copyright information in PMC

References

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    1. Queensland Paediatric Sepsis Program at Children's Health Queensland , Queensland Family and Child Commission . Queensland Paediatric Sepsis Mortality Study. Queensland: Queensland Government, 2024.

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